This year in state houses across the country Medicaid expansion discussions will once again take center stage, and the administration will be ramping up pressure on governors and legislatures to expand the safety net program to cover those with household incomes up to 138 percent of the federal poverty level (FPL).
A key selling point of the Affordable Care Act (ACA) was the notion that increased rates of insurance would reduce Emergency Room (ER) crowding.
A recent Commonwealth Fund study analyzed the impact of the optional Medicaid expansion — in which a state could increase Medicaid eligibility to all state residents under 138 percent of the Federal Poverty Level (FPL) — on overall federal transfers to the states. The report concludes that expanding Medicaid is a net positive for all states. At the heart of the conclusion is the argument that the states’ budgetary contribution, which will eventually hit 10 percent of the costs for the newly eligible, is a “cheap” way to improve the state budget.
Presumptive eligibility is a rarely discussed provision of the Affordable Care Act (ACA) which is likely to result in wasteful Medicaid spending, placing an increased financial burden upon states.
The most common criticism of the Affordable Care Act’s (ACA) Medicaid expansion is that it will cost the federal government, states, and taxpayers hundreds of billions of dollars in the coming years. A study released this week by professors from the University of Michigan posits that expansion of the program may actually result in lower than expected costs, thanks to an increase in younger, healthier enrollees. However, the lifestyle choices of these young, newly eligible beneficiaries may, in fact, have the opposite effect on program expenditures long term.
There are a variety of proposals for reforming the Medicaid program, one of which is per-capita caps on annual spending.
Just yesterday the CBO delivered its latest sobering warning regarding the nation’s fiscal future, making the point once again that Medicare and Medicaid programs are in need of fundamental reforms in order to both remain solvent and prevent the country from complete economic collapse. This will, of course, be a larger conversation over the next several months as the budget season begins, but there are components within each of those programs that deserve a second look.
On paper, Medicaid is the best health plan anywhere. It covers almost every imaginable service, with zero payment due from the patient. In practice, the reality of Medicaid is quite different. Patients have insufficient access to health care providers and lack of coordination and continuity of care, mainly because of low payment rates; despite this, states and the federal government face rapid growth in total program costs.
Throughout much of its history, the Medicaid program has been plagued by three major problems: insufficient access to care for beneficiaries, lack of coordination and continuity of care, and rapid growth in total program costs.